Health & Safety

Spain should pose no major health hazards. Yes, the rich cuisine -- garlic, olive oil, and wine -- may give some travelers mild diarrhea, so take along some anti-diarrhea medicine, moderate your eating habits, and even though the water is generally safe, drink mineral water only. Fish and shellfish from the polluted Mediterranean should only be eaten cooked, though in Madrid most seafood comes from the cleaner Atlantic-washed northern provinces and you might risk the odd raw percebe (goose barnacle) if you can afford it.

If you're traveling around Spain (particularly southern Spain) over the summer, limit your exposure to the sun, especially during the first few days of your trip and, thereafter, from 11am to 2pm. Use a sunscreen with a high protection factor and apply it liberally. Remember that children need more protection than adults do.

The water is safe to drink throughout Spain; however, do not drink the water in mountain streams, regardless of how clear and pure it looks.

General Availability of Healthcare -- No shots of any sort are required before traveling to Spain. Once there, medicines for a wide variety of common ailments from colds to diarrhea can be obtained over the counter at local chemists or farmacias. Generic equivalents of common prescription drugs are also usually available in Spain. (However, it does no harm to bring OTC medicines with you to be on the safe side.)

Contact the International Association for Medical Assistance to Travelers (IAMAT; tel. 716/754-4883 or, in Canada, 416/652-0137; www.iamat.org) for specific tips on travel and health concerns in Spain and for lists of local, English-speaking doctors. The United States Centers for Disease Control and Prevention (tel. 800/311-3435; www.cdc.gov) provides up-to-date information on health hazards by region or country and offers tips on food safety. The website www.tripprep.com, sponsored by a consortium of travel medicine practitioners, may also offer helpful advice on traveling abroad. You can find listings of reliable clinics overseas at the International Society of Travel Medicine (www.istm.org).

Common Ailments

Change of Diet -- You'll have no need to go on a tempting cholesterol binge if you really don't want to. Vegetarians can follow their usual diet pattern in Madrid, as an increasing number of vegetarian eating spots is available as well as a multitude of herbolarios, or health food shops.

High-Altitude Hazards -- Madrid is nearly 2,000 feet above sea level, but this does not usually trigger respiratory problems. Care should be taken, however, if you decide to climb up to the top of the 7,500-foot-high Guadarrama mountains -- a feat performed by a surprising number of people on the steep but relatively easy path access from Cotos.

Sun Exposure -- Madrid has a dry, sunny climate (more than 300 cloudless days a year), and it's best to take protective measures against sunburn and heatstroke. This is particularly valid in May and June when the days are long and the sun's rays are deceptively intense. The temperatures at those times are not as oppressive as those of July and August, when you feel more inclined to stay in the shade or seek solace in an air-conditioned locale.

Visitors with eyesight problems should also take care to avoid the sun's strong glare, using prescribed sunglasses.

What To Do If You Get Sick away from Home

Spanish medical facilities are among the best in the world. If a medical emergency arises, your hotel staff can usually put you in touch with a reliable doctor. If not, contact the American embassy or a consulate; each one maintains a list of English-speaking doctors. Medical and hospital services aren't free, so be sure that you have appropriate insurance coverage before you travel.

Pack prescription medications in your carry-on luggage. Carry written prescriptions in generic, not brand-name form, and dispense all prescription medications from their original vials. Also bring along copies of your prescriptions in case you lose your pills or run out.

If you suffer from a chronic illness, consult your doctor before your departure. Pack prescription medications in your carry-on luggage, and carry them in their original containers, with pharmacy labels -- otherwise they won't make it through airport security. Carry the generic name of prescription medicines, in case a local pharmacist is unfamiliar with the brand name.

For travel abroad, you may have to pay all medical costs upfront and be reimbursed later.

Staying Safe

Terrorism -- Since the Al Qaeda bomb attacks on three suburban trains in and around Atocha station on March 11, 2004, resulting in the deaths of 200 people, both political and public attention in Spain has been strongly focused on the global nature of terrorism now threatening Western society.

A direct or indirect consequence of the massacre was that after a massive protest demonstration of two million people in the streets of the city, voters unexpectedly returned the Socialist party to power in the March 14 general elections. (The policy of the new president Rodríguez Zapatero had always been to oppose the war in Iraq, and one of his first acts was to authorize the full withdrawal of Spanish troops from that country just over 3 months later.)

Life in Madrid continued more or less unchanged after this event, even though the memory of it remains indelible. To date there is nothing to suggest that Islamic terrorism constitutes a more serious threat in Madrid than in any other major world city. U.S. tourists traveling to Spain should, however, exercise caution and refer to the guidance offered in the Worldwide Caution Public Announcements issued in the wake of the September 11, 2001, terrorist attacks, now also bearing in mind the 2004 tragedy in Madrid.

The homegrown terrorist problem of ETA, the Basque separatist movement, has meanwhile taken a more hopeful turn. After 4 decades of deadly bomb attacks on police and public (even including tourists), the ETA announced a "permanent" ceasefire in 2006. Subsequent negotiations between the PSOE government helmed by the pragmatic Rodríguez Zapatero and the outlawed Herri Batasuna party, the front for ETA, have led to cautious optimism for a peaceful settlement of the problem. The opposition PP party under Mariano Rajoy is, however, adamant in their refusal to support any form of discussion with what they regard as simply a terrorist group and have successfully stage-managed several mass demonstrations of protest to this effect. Therefore, the outcome at press time remains largely in doubt.

A smaller Marxist group, GRAPO, which also mounted several attacks since 1999 and killed three people, has in recent years been inactive.

"Conventional" Crime -- While most of Spain has a moderate rate of "conventional" crime, and most of the estimated one million American tourists enjoy trouble-free visits to Spain each year, the principal tourist areas have been experiencing an increase in violent crime. Madrid has reported growing incidents of muggings and violent attacks, and older tourists and Asian-Americans seem to be particularly at risk. Criminals frequent tourist areas and major attractions such as museums, monuments, restaurants, hotels, beach resorts, trains, train stations, airports, subways, and ATMs.

Reported incidents have occurred in key tourist areas, including the zones around the Prado Museum and Atocha train station, and parts of Old Madrid like Sol, El Rastro flea market, and Plaza Mayor. Travelers should exercise caution, carry limited cash and credit cards, and leave extra cash, credit cards, passports, and personal documents in a safe location. Crimes have occurred at all times of day and night, though visitors -- and residents -- are more vulnerable in the early hours of the morning.

Thieves often work in teams or pairs. In most cases, one person distracts a victim while the accomplice performs the robbery. For example, a stranger might wave a map in your face and ask for directions or "inadvertently" spill something on you. While your attention is diverted, an accomplice makes off with the valuables. Attacks can also be initiated from behind, with the victim being grabbed around the neck and choked by one assailant while others rifle through the belongings. A group of assailants may surround the victim, maybe in a crowded popular tourist area or on public transportation, and only after the group has departed does the person discover he/she has been robbed. Some attacks have been so violent that victims have needed to seek medical attention afterward.

Theft from parked cars is also common. Small items like luggage, cameras, or briefcases are often stolen from parked cars. Travelers are advised not to leave valuables in parked cars and to keep doors locked, windows rolled up, and valuables out of sight when driving. "Good Samaritan" scams are unfortunately common. A passing car will attempt to divert the driver's attention by indicating there is a mechanical problem. If the driver stops to check the vehicle, accomplices steal from the car while the driver is looking elsewhere. Drivers should be cautious about accepting help from anyone other than a uniformed Spanish police officer or Civil Guard.

The loss or theft abroad of a U.S. passport should be reported immediately to the local police and the nearest U.S. embassy or consulate. U.S. citizens may refer to the Department of State's pamphlet, "A Safe Trip Abroad," for ways to promote a trouble-free journey. The pamphlet is available by mail from the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402, via the Internet at www.gpoaccess.gov/index.html, or via the Bureau of Consular Affairs home page at http://travel.state.gov.

Dealing with Discrimination

As Madrid's population slowly becomes more international, overt racial prejudice -- never a dominant issue here anyway -- appears to be diminishing there will always be a hardcore group of people, such as the fascist fringe supporters of certain Spanish football clubs, whose attitude is affected simply by the color of a person's skin.

Still, since the March 11 bombings of 2004, there has been a slight hardening of attitudes towards Arabic nationalities by certain members of the community. Some residents' attitudes towards Latin Americans have been soured by the appearance (in relatively small numbers) of young L.A.-style South American criminal gangs such as the Latin Kings and Dominicans Don't Play in the outer areas of the city.

On the sexual front, the city is as liberal as any regarding gay lifestyles, including homosexual marriages, which are widely accepted.

Solo female travelers and residents can also live a reasonably hassle-free existence.

A Note on Discrimination -- A fierce sense of national pride might lead many Spaniards to bristle at the suggestion that racism is a problem in their country, but recent events and a new report by Amnesty International have brought to the fore concerns over racism and racial profiling in Spain. In January 2002, Rodney Mack, an African American and the principal trumpet player with the Barcelona Symphony Orchestra, was attacked and beaten in Madrid by four police officers who later said they mistook the musician for a car thief. The thief had been described as a black man of roughly Mr. Mack's height, and a police official later admitted that Mack was singled out because of "the color of his skin and his height." In April 2002, Amnesty International cited the Mack case in an exhaustive report accusing Spain of "frequent and widespread" mistreatment of foreigners and ethnic minorities. The report investigated more than 320 cases of abuse from 1995 to 2002, including deaths and rapes while in police custody, as well as beatings, verbal abuse, and the use of racial profiling by police. The report claims that an increase in racist attacks in Spain has coincided with a dramatic growth in the country's immigrant population over the last 20 years. Spanish officials, however, rejected the report, and Congressman Ignacio Gil-Lázaro of Spain's ruling Popular Party said, "The police and Civil Guard confront immigration in a deeply humanitarian way."

While Amnesty's report may rightfully dispel the notion that Spain is exempt from the problems of racism, it does not suggest that the country is Europe's only offender. In recent years, Amnesty has pointed at race-based abuses in numerous European nations, including Austria, Greece, and Italy, as well as in the United States. Travelers of color may have a perfectly enjoyable trip in Spain, but visitors to the area should travel with the knowledge that racism and xenophobia is a growing concern. If you encounter discrimination or mistreatment while traveling in Spain, please report it to your embassy immediately. -- John Vorwald